ER, Hospitalization and Urgent Care Entry Form

Please enter your full name.

For example, Adella House or New Lenox Woodworks

6. Individual's Level of Mobility
8. Gender
9. Type of Report
11. Day of the Week
12. Person Recommending the Visit
13. Was 911 used?
14. Was the physician notified prior to the visit?
15. When was the guardian notified?
16. Is there an Unusual Incident Report associated with this visit?
18. Is this the first visit for this problem?
22. Disposition from ER/Hospital
Please provide the following information in #25:

1. What led up to the event described above?

2. What was the exact issue that caused the event?

3. What was staff's immediate response to the event?

4a. What testing was done?

4b. What was the results of the testing?

5. What treatment was ordered as a result of the testing?

6. Is there any follow-up needed related to this event?

Please give a brief, specific description that includes all requested information (see instruction above).

Independent Living Coach/Direct Support Professional (DSP) (Joliet, IL) Overnight Shift



Location: Joliet, IL

Salary Range: $13.22/hr

Shift: Third Shift - 10:30pm-8:30am

Schedule: Full time, 4 days a week, some weekends required

    - Overtime opportunities available!

    - Benefits available!


When you join the Trinity team, you become a member of a culture of kindness – a community that truly cares about you and the people we support. You will meet lifelong friends and experience ample opportunities for personal and professional growth as you help people with disabilities and mental illness flourish and live full and abundant lives.

Come and be a part of an organization where you have the ability to make an impact every day! Use your talents and skills to make a difference in the lives of those with disabilities at Trinity Services, Inc. An Independent Living Coach (ILC) provides services and supports to individuals with disabilities in community residences and day services. Join our team today!

Job duties for an Independent Living Coach include:

- Accompany the people we support to community events such as sporting events, museums, shopping, and other fun activities

- Helping with everyday tasks, such as personal care, social interactions, and preparing meals

- Transportation to jobs and appointments

- Participating in a variety of activities that teach, maintain, and/or strengthen skills for a more independent lifestyle

Minimum Requirements: High School Diploma or GED, Clean background check, and pass physical exam and basic reading comprehension test.


-Health and dental insurance

-Paid vacation, sick time, and personal time

-Unlimited referral bonuses

-Employee bonus based on performance

-Advancement opportunities

-Overtime availability

-Helping people in significant ways every day

*Benefits vary for full-time and part-time!

Contact Information: Laurie Ferfecki at